GPs can compete with private firms

When I read your story about private firms dropping out of the Darzi tender, my first thought was how things have moved on.

It was not too long ago that the discussion was about how private companies could be predators.

In reality, anyone who understands the process for submitting the initial expression of interest, and more importantly the pre-qualifying questionnaire, appreciates those entering the market for the first time have a huge advantage.

It is a sign that such companies have commercial reasons for not proceeding further at this stage, whatever those reasons may be.

GPs as independent contractors can equally compete with such organisations. What we must not lose sight of is that contracts are being given to those who can demonstrate they can deliver according to local needs.

If they don't, then remedial action will be taken and ultimately contracts will be revoked. Primary care is to change (again) and it is for everyone to adapt.